| Decisions around the investment of resources, adoption and integration of innovations and new technologies into surgical practice are difficult. Health technology assessment is a systematic evaluation of a "health technology". It bridges a body of scientific inquiry with policy making to assist in technology decisions. In this thesis, the approach to and methods of health technology assessment are applied to a common surgical disease and its treatment. Acute pancreatitis is a reversible inflammatory state of the pancreas. Severe cases are treated with resting the pancreas, intravenous fluid therapy, general medical support and nutrition. The optimal choice of nutritional support is controversial; therefore, we conducted a randomized, controlled trial comparing parenteral with enteral nutrition. The results indicate both parenteral and enteral nutrition are safe and provide adequate nutrition. Enteral nutrition seems to attenuate pancreatic inflammation and is the dominant technology in terms of cost effectiveness.{09}Using the HTA process, we concluded that enteral nutrition should be adopted, integrated and utilized. |
